三孩政策下孕妇血小板抗体筛查的临床价值

Clinical value of platelet antibody screening in pregnant women under the three-child policy

目的分析329例孕妇血小板抗体阳性结果,探讨血小板抗体与妊娠次数和流产史的关系。方法选取2017年1月—2021年12月厦门大学附属第一医院329例住院孕妇为研究对象,采用固相凝集法进行血小板抗体筛查,分析孕妇血小板抗体阳性率与年龄、妊娠次数和流产史等因素之间的关系。结果329例孕妇中,血小板抗体阳性50例,阳性率15.198%;经产妇血小板抗体阳性率(19.431%)高于初产妇(7.627%),差异具有统计学意义(P<0.05),妊娠次数不同阳性率不同(1次7.627%,2次17.582%,>2次20.833%),三者差异具有统计学意义(P<0.05),组间趋势χ^(2)检验显示妊娠次数和血小板抗体有线性趋势(P<0.05);有流产史的孕妇抗体阳性率(23.529%)大于无流产史(13.027%),二者差异具有统计学意义(P<0.05);年龄对孕妇血小板抗体阳性率无影响(P>0.05)。结论孕妇妊娠次数和流产史与血小板阳性率密切相关,妊娠孕妇应该进行血小板抗体筛查,特别是有妊娠史和流产史的孕妇更应重视,这对于预防和减少孕期流产和胎儿/新生儿同种异体免疫血小板减少症(fetal and neonatal alloimmune thrombocytopenia,FNAIT)具有重要的临床意义。

Objective Positive results of platelet antibodies in 329 pregnant women were analyzed to explore the relationship between platelet antibodies and pregnancy number and history of miscarriage.Methods 329 pregnant women hospitalized from January 2017 to December 2021 were selected as the study subjects for platelet antibodies by solid phase agglutination method.The relationship between the rate of platelet antibody and age,pregnancy number and abortion history were analyzed.Results Among the 329 pregnant women,50 patients were positive for platelet antibodies,with a positive rate of 15.198%.The positive rate of platelet antibody in pluriparas(19.431%)was higher than that of primiparas(7.627%),and the difference was statistically significant(P<0.05).Different positive rates of different pregnancies(1 time:7.627%,2 time:17.582%,>2 time:20.833%),the three differences were statistically significant(P<0.05).Inter-group?test showed linear trends in the number of pregnancies and platelet antibodies(P<0.05).The antibody positive rate of pregnant women with abortion(23.529%)was greater than that without abortion(13.027%),and the difference was statistically significant(P<0.05).Age had no effect on the platelet antibody positive rate in pregnant women(P>0.05).Conclusion The number of pregnant pregnancies and the history of miscarriage were closely correlated with the platelet positive rate.Pregnant women should be screened for platelet antibodies,especially those with a history of pregnancy andabortion.This is of great clinical significance for the prevention and reduction of pregnancy abortion and fetal/neonatal allograft-immune thrombocytopenia(FNAIT).